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Background: Racial patterns of health and disease have little, if anything, to do with genes. Instead, they reflect patterns of social and economic inequity based on socially constructed ideas about race. To put it another way, race (in a fixed biological sense) doesn't cause illness,racism does.

Media stories regularly attribute racial differences in health outcomes to innate or genetic variation between "races." One such example - repeated on Oprah not so long ago - is the "salt retention gene" hypothesis that purportedly explains high rates of hypertension among African Americans. The problem is, there's scant evidence to support these claims.

Here are a few reasons why:

Race doesn't exist biologically. Science has shown that humans simply do not come packaged into a few groups. That's because genes are inherited independently and traits vary "non-concordantly." Skin color doesn't cluster with hair texture, blood type, lactose intolerance or genetic markers for disease. In fact, there's not a single gene, trait or characteristic that separates all the members of one so-called race from all members of another.

Moreover, racial categories are socially constructed, not scientifically based. Ancient civilizations like the Greeks didn't sort people by physical appearance but by language and status. Even today, racial classification varies from one country to the next, and in the U.S., our own categories have changed over time. Scientifically speaking, skin color literally is only skin deep.

Findings on health differences don't support biological notions of race. Disease patterns can be misleading. Many biologists looking to unravel racial differences in health almost instinctively assume there's an innate or genetic cause. After all, our eyes tell us that people are different, don't they? As anthropologist Alan Goodman reminds us, it's easy - but incorrect - to believe that the sun revolves around the earth.

For example, we know that African Americans suffer the highest hypertension rates of any U.S. population. But Richard Cooper and his colleagues found that hypertension rates in western Africa (the ancestral home of many African Americans) are among the lowest in the world, a third less than for African Americans. Meanwhile, Germans have very high hypertension rates, much higher than both white and Black Americans. If predisposition to hypertension were truly "racial," recent African-origin populations would share similar rates of illness, as would the European-origin populations. But they don't.

Other research bears this out. African American women give birth to a disproportionately high number of low-birth weight babies - weighing on average half a pound less than the babies of white American women. But Richard David and James Collins found that babies born to African immigrants to the U.S. weighed the same as the white babies. David and Collins also discovered something else: the daughters of African immigrants delivered babies weighing an average half pound less than those born to white women and their own mothers. As Collins describes it, "Something is driving this that's related to the social milieu that African American women live in throughout their entire life."

To take another example, almost half of all adult Pima Indians in southern Arizona have Type 2 diabetes, perhaps the highest rate in the world. But their Pima brethren living across the border in Mexico have diabetes rates of less than 7% (similar to the U.S. average). Genes that are believed to identify predisposition to diabetes have so far been found in every population where geneticists have looked, not just among the Pima.

Finally, a few years ago the drug Bidil was touted widely as the first "racial" drug when the FDA approved its use for African Americans with congestive heart failure. No one disputes that Bidil can be an effective treatment, but clinical trials didn't test the drug's effectiveness between populations. In fact, evidence suggests that it works for members of all populations, not just African Americans. The drug company even told Wall Street analysts that it's counting on "off label" use with other groups. But by securing FDA approval for African American use only, the drug company, through a twist in U.S. patent law, was able to extend its exclusive right to Bidil by a dozen years. Race, in this case, is simply a convenient marketing tool to be exploited for profit.

Genes can certainly affect disease risk on an individual level. Also, some populations do have different frequencies of particular "alleles," gene variants, like the A, B & O blood groups. But those allele patterns don't neatly divide along 'racial' lines. People from Lithuania and Papua New Guinea, for example, have the same proportions of AB and O blood.

As sociologist Troy Duster sums it up, the impact of race on disease is not biological in origin but in effect. Searching within the body for the source of population disease differences diverts our attention from addressing the true social, not biological origins lurking outside the body.

This document by California Newsreel provides an overview of how social concerns such as income, jobs, education, housing, and racism relate to health outcomes and inequities. The short pieces in this document are taken from the topic introductions in the Health Equity database on the UNNATURAL CAUSES Web site.

Dr. Donald Warne talks about how cultural loss impacts the health of Native American tribes in Arizona. The damming of rivers plunged local tribes into poverty, dependence and ultimately poor health. Deprived of their language, land, livelihood and traditions, many Native Americans have developed a fatalistic view about diseases like diabetes.

The U.S. government has spent hundreds of millions of dollars over the past 40 years trying to uncover a biological explanation for why the Pima Indians of southern Arizona have one of the highest rates of diabetes in the world. But as Dr. Donald Warne tells us, diabetes was extremely rare here 100 years ago. What's changed? Not biology but environment.

SCHOLARLY ARTICLE by Richard David and James Collins, American Journal of Public Health, 2007

Since 1950, dramatic advances in human genetics have occurred, racial disparities in infant mortality have widened, and the United States' international ranking in infant mortality has deteriorated. The quest for a "preterm birth gene" to explain racial differences is now under way. Scores of papers linking polymorphisms to preterm birth have appeared in the past few years. Is this strategy likely to reduce racial disparities? A review of broad epidemiological patterns contradicts the genetic theory of race and points toward social mechanisms.A subscription is required to access the full article online.

O’odham Indians, living on reservations in southern Arizona, have perhaps the highest rates of Type 2 diabetes in the world. Forty years of poking and prodding by medical researchers have yielded few improvements, as disease rates continue to rise. But the O’odham and other Native communities are taking matters into their own hands – finding hope for their health by strengthening ties to traditional culture, fighting for their rights, and trying to regain control over their destinies.

On June 23, 2005, the U.S. Food and Drug Administration (FDA) formally approved the heart failure drug BiDil to treat heart failure in self-identified black patients. The drug itself is not actually new; it is merely a combination of two generic drugs that have been used to treat heart failure for over a decade. BiDil's newness derives primarily from its public presentation as the world's first ethnic drug.

This analysis begins with a consideration of the race-specific clinical trials that preceded the FDA approval and then moves on to elaborate upon some of the broader implications of BiDil in the context of genomic medicine and the politics of heath care. It briefly relates the story of how law and commerce played a central role in the emergence of BiDil as an ethnic drug. Then it explores the strategic reification of race as genetic in the context of BiDil and connects the drug to larger issues concerning genetics and the politics of difference in health care and perhaps beyond.

The Center on the Developing Child was founded in 2006 on the belief that the vitality and sustainability of any society depend on the extent to which it provides opportunities early in life for all children to achieve their full potential and engage in responsible and productive citizenship. We view healthy child development as the foundation of economic prosperity, strong communities, and a just society, and our mission is to advance that vision by leveraging science to enhance child well-being.

Jennifer Poudrier, an associate professor of sociology at the University of Saskatchewan, is one of many scholars to argue that the "thrifty gene" theory allows society to curl up with the notion that biology shoulders most of the blame for the ill health of native people. She dismisses it as “a colonial lens put on aboriginal history,” promoting the myth that indigenous people all have the same genes that make their diabetes “a special problem” beyond the reach of public-health initiatives.

Our eyes tell us that people look different. But how different are we beneath the skin? Geneticists, anthropologists, and biologists are unlocking human variation and the evolution of our species. Let's see what they're finding out:

Test what you know about human diversity, and learn why race isn't biological.

Like a game of whack-a-mole, the "slavery hypothesis" of hypertension keeps popping up in the media, popular culture and even medical texts no matter how many times it is slammed down. It has come to symbolize the incessant way in which unfounded biological theories of racial difference continue to thrive despite significant evidence to the contrary.

What is this thing we call 'race'? Where did the idea come from? What are the patterns of human variation? And if race isn't biological, what is it? How do our social institutions 'make' race? Used widely in classrooms and community spaces, This acclaimed three-part series compels viewers to scrutinize some of their most fundamental beliefs.

This paper, prepared by staff at The Opportunity Agenda and California Newsreel, provides background, statistics, and theoretical frameworks to help the reader better understand the role that "race" plays in health inequities. Evidence is presented that discounts popularly accepted genetic explanations and supports theories of socially-based factors.

ARTICLE by Robert Wallace, Department of Biology at the City College of New York

Several writers have recently claimed that new genomics findings demonstrate that race is biologically real after all, perhaps most notably Armand Marie Leroi's New York Times op-ed of March 14, 2005. This excellent article by Robert Wallace disputes that assertion.

This article, co-authored by 14 highly respected geneticists, sociologists, and anthropologists, presents some of the unintended consequences of the boom in genetic ancestry testing. They explain how these tests "have significant scientific limitations" yet may be "serious matters for many test-takers."

According to a new study in Molecular Psychiatry, violence leaves long-term scars on children's bodies, altering their DNA and causing changes that are equivalent to seven to 10 years of premature aging. Scientists measured this cellular aging by studying the ends of children's chromosomes, called telomeres.

We all know that people look different. Anyone can tell a Czech from a Chinese. But are these differences racial? What does race mean? Find the answers to these and other questions by exploring different interactivities within this site.

Report on a new study that indicate that where a child lives, including factors such as the neighborhood's walkability, proximity to higher quality parks, and access to healthy food, has an important effect on obesity rates.

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DID YOU KNOW:

The U.S. child poverty rate is by far the highest among rich nations. Children in poverty are 7 times more likely to be in poor or fair health than the rich.